Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The pulmonary veins and venules in lungs of newborn infants with hyaline membrane disease can be completely filled with a barium sulfate solution. The same injection technique and combined roentgenological, histological, and histometrical investigations also reveal a defect in filling of many small muscular arteries and of most pulmonary arterioles. Hence, the latter pulmonary vessels are assumed to be important in pulmonary ischemia, as demonstrated in the respiratory distress syndrome of the newborn infant.
 ...
PMID:Pulmonary venous vasculature in neonatal hyaline membrane disease. 564 70

The authors report twenty two cases of post-operative gas gangrene. In the series studied mortality was 40.9 p. 100, independent of age and sex. Rapidly progressive forms were the most severe. The delay before effective treatment was prescribed influenced prognosis. In clinical terms, shock and associated renal insufficiency were grave, as well as a picture of respiratory distress which led, in certain cases, to contra-indication of one of the therapeutic possibilities, i.e. that of hyperbaric oxygen. Responsible organisms could be isolated in nineteen cases from local samples. There was a marked predominance (15 cases) of clostridium perfringens. Contamination with aerobic flora was common. Examination to assess favourizing circumstances led essentially to a conclusion of the role of microbial contamination, ischemia, broad spectrum antibiotics, absence of appropriate antibiotics and underlying immuno-depression. Treatment was based in the majority of cases on the triple combination of antibiotics, surgery and hyperbaric oxygen, as well as the correction of any general systemic disorders. Mortality was markedly reduced (31 p. 100) in patients receiving complete and early treatment. The gravity and recrudescence of disorders due to anaerobic organisms lead the authors to review current therapeutic possibilities. Appropriate treatment should be prescribed in all situations where an infection due to anaerobic organisms is feared, and should cover the risk of clostridial infection (penicillin 200,000 mu/kg/24 h) as well as the risk of bacteroides (metronidazole 25 mg/kg/24 h). Curative treatment should be prescribed, even in the absence of bacteriological proof, on the basis of presumptive clinical evidence, this being a true emergency which should not be delayed under any circumstances.
 ...
PMID:[Postoperative gas gangrene. Apropos of 22 cases]. 611 45

Dopamine, ethanol, and mannitol were investigated to determine if they could increase pulmonary blood flow and oxygen delivery without significantly increasing intrapulmonary shunt. These drugs were studied in adult patients with respiratory distress following trauma, operation, or sepsis. Intravascular pressure, cardiac output, oxygen consumption and delivery, and limb blood flow and peripheral oxygen delivery were measured in all patients. Hypotensive patients received dopamine in incremental doses of 2 mu g/kg/min until either mean arterial pressure increased 15 mm Hg or heart rate increased by more than 15 beats/min. Ethanol was given as 10% ethanol in 5% dextrose at 2 ml/kg/hr. Mannitol was given as 25 gm of a 25% solution in a single bolus followed by infusion of 8 to 25 gm of 20% solution (mean 10 +/- 2 gm) as a continuous intravenous drip over 1 hour. No drug produced a significant change in intrapulmonary shunt. Ethanol produced significant (p less than 0.05) increases in cardiac index, heart rate, oxygen consumption, and oxygen delivery. Dopamine significantly decreased pulmonary vascular resistance while increasing systemic blood pressure. Visceral blood flow apparently increased while the peripheral vascular response to ischemia remained intact. Mannitol increased oxygen delivery and consumption in both the total body and limb. Thus in patients with adult respiratory distress syndrome (ARDS), increases in pulmonary blood flow can be achieved with several distinct pharmacologic agents without significant increases in intrapulmonary shunt. These increases in flow are generally accompanied by increases in oxygen delivery without increased pulmonary vascular resistance.
 ...
PMID:Effects of dopamine, ethanol, and mannitol on cardiopulmonary function in patients with adult respiratory distress syndrome. 678 9

Interleukin-1 (IL-1) is a highly potent molecule that has a myriad of effects in biologic systems. This brief review describes some of our findings on the effects of IL-1 in biologic systems. On the one hand, IL-1 treatment caused a neutrophil-dependent acute edematous lung injury that resembled changes in the lungs of patients with the acute respiratory distress syndrome (ARDS). On the other hand, IL-1 pretreatment conferred a tolerance to lung oxidative lung injury and ischemia-reperfusion insults--again conditions manifest in sick patients. The potential mechanisms responsible for these seemingly paradoxical influences of IL-1 are described and related to possible strategies for the treatment of patients with ARDS, ischemia-reperfusion disorders, and other oxidant-mediated conditions.
 ...
PMID:Interleukin-1-mediated acute lung injury and tolerance to oxidative injury. 770 11

The lung is particularly exposed to various inhaled toxic products whose toxicity can be at least partly mediated by the generation of free radicals. Oxidants burden can also result from lung metabolism of xenobiotics or from activation of phagocytes. Free radicals are mainly derived from an univalent sequential reduction of molecular oxygen. Mitochondria is the main location of intracellular production which may also result from auto-oxidation of small molecules or function of some enzymes. To prevent the deleterious effects of free radicals produced by normal metabolism, cells are equipped with an antioxidant system composed of enzymes (superoxide dismutase, catalase, glutathione peroxidase) and non enzymatic substances such as glutathione, iron chelators, vitamin E and C, ceruleoplsamin). Targets of free radicals toxicity are phospholipids by initiation of lipid peroxidation, proteins which may be activated or inactivated via oxidation of sulfhydryl residues. Another target is DNA with possible strand breaks or mutation. Transcription activities can be also altered and it has been recently reported that some transcription factors such as NF-kB can be activated by oxidants. Under these circumstances free radicals may be considered as second messengers. Lung oxygen toxicity has been largely studied. Oxygen-induced lung lesions are non specific. It is possible to induce a resistance to 100% O2 by the pre-exposure of animals to 85% O2. This tolerance phenomenon is associated with an increased lung content in antioxidant substances. The mechanisms of gene regulation of antioxidant enzymes are still poorly understood in eukaryotes. Overproduction of free radicals in the lung is also involved in various clinical settings such as ischemia-reperfusion, exposure to ozone or NO2, acute respiratory distress syndrome, drug induced lung toxicity, pathogenesis of COPD, asthma, cancer and ageing. The precise role of free radicals among other mechanisms of lung injury is still unclear. A better knowledge of free radicals mechanisms of toxicity and of antioxidant regulation is needed to develop antioxidant therapeutic strategies.
 ...
PMID:[Free radicals and respiratory pathology]. 773 56

Oxygen free radicals may be implicated in the pathogenesis of both ischemia-reperfusion damage and in circulatory shock. The attack on the cell membrane by free radicals leads to lipid peroxidation, which can be assessed by the plasma malondialdehyde (MDA) level. The aim of this study was to determine the importance of lipid peroxidation in critically ill patients. The MDA level was measured by the thiobarbituric acid test. Nineteen patients at an early stage of circulatory shock, 11 patients in the weaning period of ventilation, 9 gastro-enterological patients without cardio-circulatory distress or sepsis, and 9 healthy volunteers were studied. The MDA level was higher in critically ill patients than in control subjects (61% in patients with shock and 40% in patients on mechanical ventilation). No correlation was found between the MDA level and the outcome: multiple organ failure or acute respiratory distress syndrome. This proposal leads to the question of systematic antioxidant therapy in intensive care patients.
 ...
PMID:Plasma lipid peroxidation in critically ill patients: importance of mechanical ventilation. 800 18

Three thousand sixty-six patients underwent cardiopulmonary bypass at the Maimonides Medical Center over a 5-year period from January 1, 1987, to January 1, 1992. Of these patients, 1,890 (62%) were less than 70 years of age, 969 (32%) ranged from 70 to 79 years of age, and 207 (7%) were 80 years of age or older. The overall 30-day mortality rate was 8%. Eleven patients developed acute mesenteric ischemia from 24 hours to 12 days postoperatively. At the time of diagnosis, the majority of patients presented with late classical signs and symptoms of acute mesenteric ischemia including abdominal distension, respiratory distress, hypotension, oliguria, and sepsis. All patients underwent immediate laparotomy. Extensive bowel necrosis was found in all, and resection was possible in eight patients. All patients died as a result of this complication. Using the exact trend test, we found a statistically significant increase in the incidence of deaths due to acute mesenteric ischemia after cardiopulmonary bypass in older compared with younger patients. This fatal complication after cardiopulmonary bypass occurs more often than previously believed and is a relatively common cause of death in the elderly.
 ...
PMID:Acute mesenteric ischemia after cardiopulmonary bypass. 835 21

In order for neutrophils to function effectively in host defense, they have evolved specific attributes including the ability to migrate to the site of inflammation and release an array of toxic products including proteolytic enzymes, reactive oxygen species, and cationic proteins. While these compounds are intended for killing invading pathogens, if released inappropriately, they may also contribute to tissue damage. Such inflammatory tissue injury may be important in the pathogenesis of a variety of clinical disorders including arthritis, ischemia-reperfusion tissue injury, the systemic inflammatory response syndrome (SIRS), and the acute respiratory distress syndrome (ARDS). Despite the importance of neutrophil function in host defense and dysfunction in disease states, much remains unknown about the intracellular signaling pathways regulating neutrophil activity. This review will focus on the signaling molecules regulating leukocyte 'effector' functions including receptors, GTP-binding proteins, phospholipases, polyphosphoinositide metabolism, and protein kinases and phosphatases.
 ...
PMID:Intracellular signaling in neutrophil priming and activation. 874 42

Tissue factor pathway of coagulation plays a dominant role during normal haemostasis. Tissue factor pathway inhibitor (TFPI), expressed primarily by the microvascular endothelium, appears to be the major physiologic inhibitor of TF-induced coagulation. TF-initiated coagulation also plays an important role in the pathophysiology of many diseases including coronary thrombosis, sepsis, disseminated intravascular coagulation, stroke, cancer, acute respiratory distress syndrome, and ischemia-reperfusion injury. Several animal studies have found a beneficial effect of anti-TF monoclonal antibodies and, recombinant TFPI in some of the above clinical conditions. rTFPI is presently being used in clinical trials in patients with sepsis and in those following microvascular surgery. This article discusses many of the animal studies addressing inhibition of TF-induced coagulation, as well as potential therapeutic uses of rTFPI in humans.
 ...
PMID:Tissue factor pathway inhibitor: potential therapeutic applications. 919 99

Enzymes and other factors secreted by degranulating neutrophils (polymorphonuclear leukocytes, PMNs) mediate endothelial injury, thrombosis, and vascular remodeling. In bacteremia and sepsis syndrome and their consequent complications (including acute respiratory distress syndrome and systemic ischemia-reperfusion resulting from septic shock), neutrophil degranulation is an important mechanism of injury. In related studies, we found that human endothelial cells regulate neutrophil degranulation and that inflammatory cytokines induce synthesis of degranulating factors by human endothelial cells. Here we show that lipopolysaccharides (LPS) from gram-negative bacteria were the most potent agonists for release of degranulating activity by endothelial cells when compared to several cytokines and stimulatory factors. LPS also induced the release of degranulating signals for PMNs from a human endothelial cell line, EA.hy 926. Interleukin 8 (IL-8) is synthesized by endothelial and EA.hy 926 cells in response to LPS and induces neutrophil degranulation. However, complementary strategies using receptor desensitization, translation of messenger RNA by Xenopus laevis oocytes, and purification and analysis of factors from conditioned supernatants demonstrated that degranulating factors distinct from IL8 are generated in response to LPS. The characteristics of a partially purified degranulating factor isolated from conditioned supernatants distinguished it from known chemokines and other factors that induce PMN degranulation and are generated by endothelial cells in response to LPS. Thus, cultured human endothelial cells and endothelial cell lines synthesize several unique signaling molecules that can trigger neutrophil granular secretion. If produced in vivo in response to LPS or other pathologic agonists, these degranulating signals may activate PMNs in combination or in sequence, initiating or propagating vascular damage.
 ...
PMID:Bacterial lipopolysaccharide induces endothelial cells to synthesize a degranulating factor for neutrophils. 961 46


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>